Capturing and analyzing hypoglycemic event data to identify treatment options

ABSTRACT

Systems, methods, and computer readable storage media manage low blood glucose levels. The system receives blood glucose readings, where each reading includes a blood glucose value and a respective timestamp. The system compares each blood glucose reading to a predefined hypoglycemic event threshold, and identifies hypoglycemic events when a respective blood glucose reading is below the predefined hypoglycemic event threshold. For at least a subset of the identified hypoglycemic events, the system prompts a user for information associated with each hypoglycemic event. The information requested includes one or more of: symptoms associated with the respective hypoglycemic event; perceived causes of the respective hypoglycemic event; and treatment for the respective hypoglycemic event. In response to the prompting, the system obtains feedback about the identified hypoglycemic events and provides a report that includes at least a subset of the obtained feedback.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/631,733, entitled “Systems and Methods for Capturing and AnalyzingHypoglycemic Event Data,” filed Feb. 25, 2015, which claims priority toU.S. Provisional Application Ser. No. 61/944,517, entitled “System andMethod for Capturing Hypoglycemic Event Data,” filed Feb. 25, 2014, eachof which is incorporated by reference herein in its entirety.

TECHNICAL FIELD

The disclosed implementations relate generally to managing hypoglycemicevents, and more particularly to a system for obtaining, analyzing, andpresenting hypoglycemic data.

BACKGROUND

Diabetes is taking a growing toll on the social and economic wellbeing.For example, in the United States, 8.3% of the population, an equivalentof 25.8 million children and adults, are diagnosed with the condition.In 2012, diagnosed diabetes incurred a cost of $245 billion, up 41% from2007. Hypoglycemia-related hospitalizations cost as much as $48,000dollars per event, which adds up to billions of dollars annually.

Traditionally, for people with diabetes, regular blood glucose leveltesting has been used to obtain blood glucose readings and to monitorlifestyle effects on blood glucose level. For example, some healthcareprofessionals may instruct a patient to obtain blood glucose readingssix to twelve times a day so that the patient may observe the changesassociated with particular events or time of the day. In order to obtainblood glucose readings, the patient can input blood samples into aglucose meter. The glucose meter then analyzes the blood samples andgenerates blood glucose readings.

Some glucose meters have limited tagging ability to associate one ormore readings with attributes, such as date and time or whether thereading was immediately after a meal. However, such limited taggingability cannot provide a clear picture of life style patterns related toa patient's blood glucose readings before, during, and afterhypoglycemic events. Some conventional diabetes management systemsprovide limited hypoglycemic data analysis, and do not relate apatient's blood glucose readings with hypoglycemic events. Doctors andpatients are often not recording symptoms, causes, and treatmentsproperly, and thus fail to recognize lifestyle patterns that causehypoglycemic events.

SUMMARY

The present disclosure is directed toward systems and methods thatovercome the limitations and disadvantages described above by recordinghypoglycemic data, analyzing the recorded data, and presenting theanalysis result to raise hypo awareness. As used herein, the term “hypo”is used as shorthand for the terms “hypoglycemia” and “hypoglycemic.”Using the systems in accordance with some implementations, providers,such as doctors and nurses, can determine patients' hypo unawareness andadjust patients' treatment plans accordingly. In addition, using thesystems and methods in accordance with some implementations, patientscan be more aware of their hypoglycemic events (i.e., when blood glucoselevels are too low) and symptoms so that they can be trained to avoidhypoglycemia and/or take preventative action to stop these events fromoccurring in the future.

In accordance with some implementations, a method for managing low bloodglucose levels is performed at a computer system having one or moreprocessors, a display device, and memory storing one or more programsconfigured for execution by the one or more processors. The methodincludes first receiving a plurality of blood glucose readings for aperson. In some implementations, each reading includes: a blood glucosevalue and a timestamp indicating when the respective reading was taken.The method also includes comparing each blood glucose reading of theplurality to a predefined hypoglycemic event threshold, and identifyinga hypoglycemic event when a respective blood glucose reading is belowthe predefined hypoglycemic event threshold. For at least a subset ofthe identified hypoglycemic events, the method includes prompting theperson to provide information associated with each hypoglycemic event.In some implementations, the information requested includes one or moreof: symptoms associated with the respective hypoglycemic event,perceived causes of the respective hypoglycemic event, and treatment forthe respective hypoglycemic event. In response to the prompting, themethod also includes obtaining feedback from the person about theidentified hypoglycemic events using a graphical user interface on thedisplay device and providing a report on the display device thatincludes at least a subset of the obtained feedback.

In accordance with some implementations, the obtained feedback includesfeedback regarding symptoms, feedback regarding causes, and feedbackregarding treatment.

In accordance with some implementations, the person is prompted toprovide information only for hypoglycemic events that are less than twoweeks old.

In accordance with some implementations, the method for managing lowblood glucose levels further includes determining that a severehypoglycemic event occurred when the person indicates that assistancewas required.

In accordance with some implementations, the predefined hypoglycemicthreshold is defined as a fixed value, set by the person, or set by adoctor.

In accordance with some implementations, each blood glucose reading thatis below the predefined hypoglycemic event threshold is identified as adistinct hypoglycemic event.

In accordance with some implementations, a plurality of blood glucosereadings that are below the predefined hypoglycemic event thresholdcomprise a single hypoglycemic event when the timestamps of the bloodglucose readings are within a two hour time period.

In accordance with some implementations, the provided report includes ahypo awareness grid. In the hypoglycemic awareness grid, in someimplementations, one axis of the grid shows blood glucose level, asecond axis of the grid shows reported symptoms, and each entry in thegrid indicates how many hypoglycemic events had a specific (glucoselevel, symptom) pair.

In accordance with some implementations, the provided report includes agraphical presentation of information regarding blood glucose levelsbefore and after one or more hypoglycemic events.

In accordance with some implementations, prompting the person to provideinformation associated with each hypoglycemic event includes displayinga plurality of hypoglycemic event symptom icons and recording userselection of one or more of the plurality of hypoglycemic event symptomicons.

In accordance with some implementations, prompting the person to provideinformation associated with each hypoglycemic event includes displayinga plurality of hypoglycemic event cause icons and recording userselection of one or more of the plurality of hypoglycemic event causeicons.

In accordance with some implementations, prompting the person to provideinformation associated with each hypoglycemic event includes displayinga plurality of hypoglycemic event treatment icons and recording userselection of one or more of the plurality of hypoglycemic eventtreatment icons.

In accordance with some implementations, the method for managing lowblood glucose levels further includes analyzing the hypoglycemic eventsand the obtained feedback to identify one or more patterns ofhypoglycemic events and including the identified patterns ofhypoglycemic events in the provided report.

In accordance with some implementations, the method for managing lowblood glucose levels further includes transmitting the received bloodglucose readings and obtained feedback to a second computing device toidentify one or more patterns of hypoglycemic events.

In accordance with some implementations, the identified patterns includea correlation between hypoglycemic events and time of day or day orweek.

In accordance with some implementations, the identified patternsindicate that the person is unaware when low blood glucose levels areoccurring.

In accordance with some implementations, the provided report includesone or more recommended changes to activities of the person.

In accordance with some implementations, a computer system for managinglow blood glucose levels includes: one or more processors; a displaydevice; and memory storing one or more programs configured for executionby the one or more processors including instructions for: receiving aplurality of blood glucose readings for a person. In someimplementations, each reading includes a blood glucose value and atimestamp indicating when the respective reading was taken. Theinstructions also include comparing each blood glucose reading of theplurality to a predefined hypoglycemic event threshold, and identifyinga hypoglycemic event when a respective blood glucose reading is belowthe predefined hypoglycemic event threshold. In addition, for at least asubset of the identified hypoglycemic events, the instructions includeprompting the person to provide information associated with eachhypoglycemic event. In some implementations, the information requestedincludes one or more of: symptoms associated with the respectivehypoglycemic event, perceived causes of the respective hypoglycemicevent, and treatment for the respective hypoglycemic event. In addition,the instructions include, in response to the prompting, obtainingfeedback using a graphical user interface on the display device andproviding a report on the display device that includes at least a subsetof the obtained feedback.

In accordance with some implementations, a method for managing low bloodglucose levels is performed at a computer system having one or moreprocessors and memory storing one or more programs configured forexecution by the one or more processors. The method includes firstreceiving a plurality of blood glucose readings for a person. In someimplementations, each reading includes: a blood glucose value and atimestamp indicating when the respective reading was taken. For at leasta subset of the blood glucose readings, the method includes receivingcontemporaneous information about the person that specifies:hypoglycemic symptoms associated with the respective blood glucosereading, perceived causes of hypoglycemia at the time of the respectiveblood glucose reading, and treatment for hypoglycemia at the time of therespective blood glucose reading. The method also includes determiningthat one or more of the blood glucose readings represent hypoglycemicevents when a respective blood glucose reading is below a predefinedhypoglycemic event threshold, analyzing the hypoglycemic events and thecontemporaneous information to identify one or more patterns ofhypoglycemic events, and providing a report that includes the identifiedpatterns of hypoglycemic events and at least a subset of thecontemporaneous information.

In accordance with some implementations, the method further includesdetermining that a severe hypoglycemic event occurred when thecontemporaneous information indicates that assistance was required.

In accordance with some implementations, the provided report includes ahypo awareness grid. In some implementations, one axis of the grid showsblood glucose level, a second axis of the grid shows reported symptoms,and each entry in the grid indicates how many hypoglycemic events had aspecific (glucose level, symptom) pair.

In accordance with some implementations, the provided report includes agraphical presentation of information regarding blood glucose levelsbefore and after one or more hypoglycemic events.

In accordance with some implementations, the identified patterns includea correlation between hypoglycemic events and time of day or day orweek.

In accordance with some implementations, the identified patternsindicate that the person is unaware when low blood glucose levels areoccurring.

In accordance with some implementations, the provided report includesone or more recommended changes to activities of the person.

One aspect of the disclosure is a method performed on a computer havingone or more processors and memory storing one or more programs forexecution by the one or more processors. The method includes thefollowing actions. At least one blood glucose reading is obtained. Ahypoglycemic event is identified when the blood glucose reading meets ahypoglycemic event threshold. A hypo survey associated with thehypoglycemic event is provided. User feedback from the hypo survey isobtained. Then a hypo report including at least a subset of userfeedback from the hypo survey is provided.

Another aspect of the disclosure is a method performed on a computerhaving one or more processors and memory storing one or more programsfor execution by the one or more processors. The method includesobtaining user feedback from a hypo survey comprising as follows.Information is provided to display a plurality of hypoglycemic eventsymptom icon. Then a user selection of one or more of the plurality ofthe hypoglycemic event symptom icons is recorded. Information isprovided to display a plurality of hypoglycemic event cause icons. Thena user selection of one or more of the plurality of hypoglycemic eventcause icons is recorded. Information is provided to display a pluralityof hypoglycemic event treatment icons. Then a user selection of one ormore of the plurality of hypoglycemic event treatment icons is recorded.Finally, a hypo report including at least one symptom icon, at least onecause icon, and at least one treatment icon is provided. It is notedthat in some implementations, a user requests a hypo survey because theyare feeling hypo, whether or not a hypoglycemic event has beenidentified.

Thus systems and methods are described that manage and reduce theincidence of hypoglycemia.

BRIEF DESCRIPTION OF THE DRAWINGS

For a better understanding of the aforementioned aspects of theinvention as well as additional aspects and implementations thereof,reference should be made to the Description of Implementations below, inconjunction with the following drawings in which like reference numeralsrefer to corresponding parts throughout the figures.

FIG. 1 is a block diagram illustrating a hypoglycemic event managementsystem in accordance with some implementations.

FIG. 2 is an exemplary client device used in the hypoglycemic eventmanagement system in accordance with some implementations.

FIG. 3 is an exemplary server system used in the hypoglycemic eventmanagement system in accordance with some implementations.

FIG. 4 is a flowchart representing a method of capturing hypoglycemicevent data, analyzing the data, and producing reports based on the datain accordance with some implementations.

FIG. 5A is a screen shot of at least one hypo event detection, inaccordance with some implementations.

FIG. 5B is a screen shot of no hypo event detection, in accordance withsome implementations.

FIG. 5C is a screen shot of a list of hypo events, in accordance withsome implementations.

FIG. 5D is a screen shot of a hypo survey for obtaining symptomsfeedback, in accordance with some implementations.

FIG. 5E is another screen shot of a hypo survey for obtaining symptomsfeedback including an instructive tool tip, in accordance with someimplementations.

FIG. 5F is a screen shot of a hypo survey for obtaining causes feedback,in accordance with some implementations.

FIG. 5G is a screen shot of a hypo survey for obtaining causes feedbackincluding an instructive tool tip, in accordance with someimplementations.

FIG. 5H is a screen shot of a hypo survey for obtaining treatmentfeedback, in accordance with some implementations.

FIG. 5I is another screen shot of a hypo survey for obtaining treatmentfeedback including an instructive tool tip, in accordance with someimplementations.

FIG. 5J is a screen shot of a hypo summary, in accordance with someimplementations.

FIG. 5K is a screen shot of a hypo awareness grid, in accordance withsome implementations.

FIG. 5L is a screen shot of a hypo pattern report, in accordance withsome implementations.

FIG. 5M is a screen shot of a hypo day report, in accordance with someimplementations.

FIGS. 6A-6F illustrate a flowchart representing a method of receivinghypoglycemic event data, analyzing the data, and providing reports basedon the data, in accordance with some implementations.

FIGS. 7A-7B illustrate a flowchart representing a method for managinglow blood glucose levels, in accordance with some implementations.

Like reference numerals refer to corresponding parts throughout thedrawings.

DESCRIPTION OF IMPLEMENTATIONS

Reference will now be made in detail to implementations, examples ofwhich are illustrated in the accompanying drawings. In the followingdetailed description, numerous specific details are set forth in orderto provide a thorough understanding of the present implementations.However, it will be apparent to one of ordinary skill in the art thatthe present various implementations may be practiced without thesespecific details. In other instances, well-known methods, procedures,components, and networks have not been described in detail so as not tounnecessarily obscure aspects of the implementations.

FIG. 1 is a block diagram illustrating a computer system 100 thatprovides hypoglycemic event management in accordance with someimplementations. In some implementations, the computer system 100includes client-side modules (or “module”) 106-1, 106-2 . . . executedon client devices 102-1, 102-2 . . . , at least one computing userdevice 130, and a server system 108 coupled to a hypoglycemic eventdatabase 110. The client-side modules 106 communicate with the server108 and/or the device 130 and/or the hypoglycemic event database 110through one or more communication networks 104. The client-side modules106 provide hypoglycemic event data collection, analysis, andpresentation functionality and communicate with the server 108. Theclient-side modules 106 are described in further details below withrespect to FIG. 2. The server 108 provides server-side functionality(e.g., analysis and handling requests to read/write data) for any numberof client-side modules 106, each residing on a respective client device102.

In some implementations, the client devices 102 are computing devicessuch as desktop computers, laptop computers, tablet computers, smartphones, and other mobile devices. Patients 122 can edit or enterhypoglycemic event data including blood glucose readings in addition toviewing hypoglycemic event analysis. In some implementations, thepatients 122 can connect meters 120 to their devices to obtain bloodglucose readings stored on the meters 120. Various meters 120 known inthe art can be used by the patients 122 to manually, automatically, orperiodically obtain blood glucose readings. The obtained readings arestored at the device and synchronized between the client device 102 andthe meter 120. Although FIG. 1 shows one meter 120 connected to eachclient device 102, in some implementations, more than one meter 120 canbe connected to each client device 102 in order to obtain readings.Wired or wireless connections can be used to transmit the readings to aclient device 102 for hypoglycemic event analysis. Other methods ofentering the hypoglycemic event data into a client device 102 includemanual entry and/or downloading from other computing devices or systems.These methods can be used in place of or in addition to syncing a clientdevice with a meter 120.

Upon receiving the readings, client-side modules 106 residing on theclient devices 102 capture hypoglycemic event data as described herein.In some implementations, the client-side modules 106 further performanalysis of the hypoglycemic event data including the blood glucosereadings, and present the analysis to the user 122.

In some implementations, the client device 102 transmits the data to aserver system 108 via communication network(s) 104. The data received bythe server 108 is the stored in the hypoglycemic event database 110 inaccordance with some implementations.

In some implementations, the server 108 includes one or more processors,and one or more databases. In some implementations, the server providesa web interface to one or more client side devices. The web interface toone or more client side devices facilitates the processing of input andoutput associated with the client side devices for one or moreserver-side modules. The one or more processors obtain hypoglycemicevent data, analyze the data, and transmit the analysis result to theclient devices 102 upon request. The hypoglycemic event database 110stores various information, such as user profiles and hypoglycemic eventdata. Although FIG. 1 shows the hypoglycemic event database 110 as aseparate database from the server 108, the hypoglycemic event database110 is implemented by the server 108 in some implementations.

In addition to the client devices 102 used by the patients 122,computing device 130 can be used by others to access the data as well.In some instances, other people 132 such as doctors, nurses, or medicalinsurance company personnel are authorized to view hypoglycemic eventdata. These other people 132 are sometimes referred to as providers(e.g., doctors and nurses) and payers (e.g., the insurance companies).Modules residing on the device 130 can request data from the server 108.In response, the server 108 retrieves data from the client devices 102or the hypoglycemic event database 110, and transmits the result to thedevice 130. Examples of a device 130 include a handheld computer, awearable computing device, a personal digital assistant (PDA), a tabletcomputer, a laptop computer, a cellular telephone, a smart phone, anenhanced general packet radio service (EGPRS) mobile phone, a mediaplayer, a navigation device, a portable gaming device console, a desktopcomputer, or a combination of any two or more of these data processingdevices or other data processing devices.

In FIG. 1, the client devices 102, the device 130, and the server 108are connected to the communication network(s) 104. The communicationnetwork(s) 104 can be any wired or wireless local area network (LAN)and/or wide area network (WAN), such as an intranet, an extranet, or theInternet. It is sufficient that the communication network 140 providescommunication capability between the client devices 102, the device 130,and the server.

The computer system 100 illustrated in FIG. 1 includes both aclient-side portion (e.g., the client devices 102 and/or the device 130)and a server-side portion (e.g., the server 108). In someimplementations, hypoglycemic event data processing is implementedentirely on a client device 102 or the device 130. In someimplementations, the division of functionality between the client device102 and server portions of hypoglycemic event data processing vary(e.g., configurable for individual patients 122 or specific devicetypes). For example, in some implementations, the client-side modules106 are thin-clients that provide hypoglycemic event data entry andoutput report functions, and delegate other data processingfunctionalities to a backend server (e.g., the server system 108).

FIG. 2 is a block diagram illustrating the client device 102 inaccordance with some implementations. The client device 102 typicallyincludes one or more processing units (CPU's) 202, one or more networkor other communications interfaces 210, memory 212, and one or morecommunication buses 214 for interconnecting these components. Thecommunication buses 214 optionally include circuitry (sometimes called achipset) that interconnects and controls communications between systemcomponents. The computer 200 includes a user interface 204 comprising adisplay device 206 and one or more input device(s) 208, such as akeyboard, a mouse, touch sensitive display screen, or other pointingdevice. Memory 212 includes high-speed random access memory, such asDRAM, SRAM, DDR RAM or other random access solid state memory devices;and may include non-volatile memory, such as one or more magnetic diskstorage devices, optical disk storage devices, flash memory devices, orother non-volatile solid state storage devices. Memory 212 optionallyincludes one or more storage devices remotely located from the CPU(s)202. Memory 212, or alternately the non-volatile memory device(s) withinmemory 212, comprises a non-transitory computer readable storage medium.In some implementations, memory 212 or the computer readable storagemedium of memory 212 stores the following programs, modules and datastructures, or a subset thereof:

-   -   an operating system 216 that includes procedures for handling        various basic system services and for performing hardware        dependent tasks;    -   a network communication module 218 that is used for connecting        the computer 200 to other computers via the one or more        communication network interfaces 210 (wired or wireless) and one        or more communication networks 104, such as the Internet, other        wide area networks, local area networks, metropolitan area        networks, and so on;    -   a web browsing module 219, which enables a user to communicate        over a network 108 (such as the Internet) with remote computers        or devices;    -   a blood glucose reading module 220 for receiving any number of        blood glucose readings;    -   a hypoglycemic event detection module 222 for identifying        hypoglycemic events that include one or more blood glucose        readings that reach the threshold (e.g. below 70 mg/dL);    -   a hypo event listing module 224 which displays a listing of one        or more hypoglycemic events, as illustrated in FIG. 5C below;    -   a hypo survey module 226, which prompts a user to provide        information about symptoms, causes, and treatment for        hypoglycemic events, as illustrated below in FIGS. 5D-5J;    -   a severe hypo event detection module 228 for detecting severe        hypo events based on survey feedback. Sever hypo events are        typically those hypo events where the treatment require        assistance of others;    -   a hypo report provision module 230 for providing a short report        of at least a subset of the user feedback for a plurality of        hypo events, typically during a span of time such as two weeks;    -   a summary provision module 232 where the summary includes all,        or almost all, of the feedback information obtained from the        user for an individual hypo event, as illustrated in FIG. 5J;    -   a glucose data report module 234 for producing various reports        such as a hypo awareness grid and/or hypo overview report, as        illustrated in FIGS. 5K, 5L, and 5M;    -   a doctor provision module 236 for providing information from        hypo events to a doctor, including both the blood glucose        readings as well as the feedback provided by the user regarding        symptoms, causes, and treatment; and    -   a client database 238 for storing hypoglycemic event data        including but not limited to blood glucose readings received by        the blood glucose reading module 220, hypoglycemic survey data        collected by the hypoglycemic survey module 226, among others.

Each of the above identified elements is typically stored in one or moreof the previously mentioned memory devices, and corresponds to a set ofinstructions for performing a function described above. The aboveidentified modules or programs (i.e., sets of instructions) need not beimplemented as separate software programs, procedures or modules, andthus various subsets of these modules may be combined or otherwisere-arranged in various implementations. In some implementations, memory212 stores a subset of the modules and data structures identified above.Furthermore, memory 212 may store additional modules and data structuresnot described above.

Although FIG. 2 shows a client device, FIG. 2 is intended more asfunctional description of various features that may be present in aclient device than as a structural schematic of the implementationsdescribed herein. In practice, and as recognized by those of ordinaryskill in the art, items shown separately could be combined and someitems could be separated. For example, some items shown separately inFIG. 2 could be implemented on the client 102 or portions could beimplemented on the server system 108. Furthermore, the actual number ofmodules and how features are allocated among them can vary from oneimplementation to another.

FIG. 3 is a block diagram illustrating the server system 108 inaccordance with some implementations. The server system 108 may includeone or more processing units (e.g., CPUs and/or GPUs) 302, one or morenetwork interfaces 310, one or more memory units 312, and one or morecommunication buses 314 for interconnecting these components (e.g. achipset).

The memory 312 includes high-speed random access memory, such as DRAM,SRAM, DDR RAM, or other random access solid state memory devices; and,optionally, includes non-volatile memory, such as one or more magneticdisk storage devices, one or more optical disk storage devices, one ormore flash memory devices, or one or more other non-volatile solid statestorage devices. The memory 312, optionally, includes one or morestorage devices remotely located from one or more processing units 302.The memory 312, or alternatively the non-volatile memory within thememory 312, includes a non-transitory computer readable storage medium.In some implementations, the memory 312, or the non-transitory computerreadable storage medium of the memory 312, stores the followingprograms, modules, and data structures, or a subset or superset thereof:

-   -   operating system 316 including procedures for handling various        basic system services and for performing hardware dependent        tasks;    -   network communication module 318 for connecting server system        108 to other computing devices (e.g., the client devices 102 or        devices 130) connected to one or more networks 104);    -   a blood glucose reading module 320 for receiving any number of        blood glucose readings;    -   a hypoglycemic event detection module 322 for identifying        hypoglycemic events that include one or more blood glucose        readings that reach the predefined hypoglycemic event threshold        (e.g. below 70 mg/dL);    -   a hypo event listing module 324 which displays a listing of one        or more hypoglycemic events, as illustrated below in FIG. 5C;    -   a hypo survey module 326, as described above with respect to the        hypo survey module 226 on a client device 102;    -   a severe hypo event detection module 328 for detecting severe        hypo events based on survey feedback;    -   a hypo report provision module 330 for providing a short report        of at least a subset of the user feedback, as described above        with respect to the hypo survey module 226 on a client device        102;    -   a summary provision module 332 where the summary includes all,        or almost all of the feedback information provided, as described        above with respect to the summary provision module 232 on a        client device 102;    -   a glucose data report module 334 for producing various reports        such as a hypo awareness grid and/or hypo overview report;    -   a doctor provision module 336 for providing at least some        information from the hypo report to a doctor;    -   an access control module 338 for authentication and        authorization of requests to view hypoglycemic data for a        patient 122. The access control module 338 limits access to        those individuals who are authorized (e.g., the patient herself        or the personal physician); and    -   one or more server databases 340 for storing hypoglycemic event        data, including:        -   the hypoglycemic database 110 for storing hypoglycemic event            data including blood glucose readings and hypoglycemic            survey data. In some implementations, the blood glucose            readings and survey data are received from a client device;            and        -   a user database 342 for storing user profiles and other user            data. In some implementations, the access control module 338            uses the user database 342 for authentication and            authorization.

As illustrated above, the functionality described in FIGS. 2 and 3 maybe implemented on either a client device 102, a server 108, or both.Various implementations allocate functionality between a client device102 and a server 108 in various ways. In some implementations, theallocation of functionality is configurable based on individual devices.For example, a patient 122 who primarily uses a small mobile device mayuse the mobile device for entering survey data, but may use a desktopcomputer or laptop computer to access a web application provided by theserver 108. In another case, a single device (such as a desktopcomputer, a laptop computer, or a tablet computer) may perform all ofthe functions described above, without transmitting the data to aserver. In some implementations, data may be transmitted to a server 108just so that it will be accessible by others, such as doctors andnurses.

In some implementations, the modules 320-326 are provided as part of aweb application, which can be accessed by a web browser 219 on a clientdevice 102 or device 130.

Although FIG. 3 shows a server 108, FIG. 3 is intended more asfunctional description of various features that may be present in systemwith one or more servers rather than as a structural schematic of theimplementations described herein. In practice, and as recognized bythose of ordinary skill in the art, items shown separately could becombined and some items could be separated. Furthermore, the actualnumber of modules and how features are allocated among them can varyfrom one implementation to another.

FIG. 4 is a flowchart representing a method 400 for capturinghypoglycemic event data, according to some implementations. In someimplementations, the method 400 is governed by instructions that arestored on a computer readable storage medium. The instructions areexecuted by one or more processors. Each of the operations shown in FIG.4 typically corresponds to instructions stored in a computer memory ornon-transitory computer readable storage medium. The computer readablestorage medium typically includes a magnetic or optical disk storagedevice, solid state storage devices such as Flash memory, or othernon-volatile memory device or devices. The computer readableinstructions stored on the computer readable storage medium are insource code, assembly language code, object code, or other instructionformat that is interpreted by one or more processors. Various operationsshown in FIG. 4 correspond to instructions in the modules of the serversystem 108 shown in FIG. 3 and/or the client device 102 shown in FIG. 2.Some of the processes listed in FIG. 4 are described in more detail withrespect to the user interface screens shown in FIGS. 5A-5L.

In some implementations, a client device 102 obtains (402) at least oneblood glucose reading. In some implementations, the client device 102can obtain blood glucose readings after the patient 122 connects a meter120 to the client device 102. Synchronizing the blood glucose readingswith the meter 120, the client device 102 obtains the blood glucosereadings. In some implementations, the client-side modules 106 on theclient devices 102 provide user interfaces to allow additional inputs toeach blood glucose reading as part of logging each event.

In some implementations, based on the readings, the client-side modules106 further identify (404) a hypoglycemic event when the blood glucosereading meets a hypoglycemic event threshold (i.e., the reading is belowa threshold value). In some implementations, a hypoglycemic event isconsidered to be one or more hypoglycemic readings that occur within thesame two hour time window (e.g., three hypoglycemic readings can be partof one hypoglycemic event). A hypoglycemic reading is a single bloodglucose reading that is below a predefined hypoglycemic threshold. Insome implementations, the predefined hypoglycemic threshold is a fixedvalue, e.g., 70 mg/dL. In some implementations, a user or physician mayset the value differently.

In some implementations, client-side modules 106 can detect one or morehypoglycemic events since the last synchronization. Further, as shown inFIG. 5A, the client-side modules 106 can generate a prompt or alert 502requesting a patient 122 to fill out a hypo survey (i.e., a hypoglycemicsurvey for an individual hypoglycemic event) related to the specifichypo event. On the other hand, if the client-side modules 106 do notdetect any readings that meet the hypoglycemic event threshold, theclient-side modules 106 can display a confirmation message on a userinterface, as shown in FIG. 5B. The congratulatory text in FIG. 5Bprovides positive reinforcement to the patient 122 if no hypoglycemicevents exists within two weeks of the current date. A View All button503 can cause additional hypoglycemic events (e.g., older than twoweeks) to be displayed.

In some implementations, the user interfaces as shown in FIGS. 5A and 5Bcan be displayed in response to a synchronization event. For example,when a synchronization event occurs, a prompt such as 502 illustrated inFIG. 5A is displayed shortly (e.g., within 5 seconds) if new readingscontain one or more hypoglycemic event that occurred within two weeksfrom the current time (time of the synchronization event). In someimplementations, a set of acceptance criteria can be set and used fortriggering the display of prompt 502. For example, when synchronizing ameter that contains one or more readings below 70 mg/dL in the last twoweeks, the prompt 502 can be displayed. On the other hand, when all ofthe readings are above 70 mg/dL (or the specified threshold), the prompt502 is not displayed and the client device 102 may instruct the meter tosynchronize at a subsequent time. The message “1 Hypo Event Detected” ismodified according to the actual number of identified hypo events basedon the data received.

In some implementations, the client-side modules 106 specify the timingof blood glucose readings and prompt the patient 122 with different userinterfaces to facilitate hypoglycemic event data entry. In someimplementations, when a hypoglycemic event is more than two weeks old,the patient 122 is not prompted to complete the survey. In someimplementations, hypoglycemic events that are older than two weeks areshown differently in the user interface than the hypoglycemic events inthe last two weeks. When the patient 122 has more than one hypo event inthe last two weeks, the patient is prompted to provide hypo surveyfeedback for each of them. In some implementations, the hypo events aredisplayed in reverse chronological order. In some implementations, thehypo events are displayed in order based on the severity of thehypoglycemic event, from lowest blood glucose level to highest. In someimplementations, the patient 122 can dismiss an alert by selecting“remind me later” or “I don't care” 501 as shown in FIG. 5A. In someimplementations, at the end of a day, the client-side modules 106generate a reminder to remind the user to complete any hypoglycemicevent surveys that are incomplete.

Referring back to FIG. 4, in addition to identifying hypoglycemicevents, the client-side modules 106 provide (406) a hypo events listingincluding one or more identified hypoglycemic events. For example, FIG.5C illustrates a list 505 of hypoglycemic events. If a survey is notfilled out by the patient 122 when prompted as shown in FIG. 5A, onlythe blood glucose (BG) value for that event is displayed. In addition tothe BG value, an indication (such as Start Survey 504 and/or a blooddraw symbol 506) is displayed to indicate that a report has not beenfilled out for a particular hypoglycemic event. On the other hand, if asurvey has been filled out when prompted as shown in FIG. 5A, a symbol508 is displayed. The displayed symbol 508 indicates that the user hasentered survey data. Survey entry indicators 510 are displayed as shownin FIG. 5C.

In some implementations, for multiple readings in a short time period(e.g., an hour) the client-side modules 106 cluster the readings andprompt the user for a hypo survey on the first reading in each cluster.In general, the patient 122 need not report data for the other readingsin each cluster. When the patient 122 does not enter data for the otherreadings, the survey can be applicable to each of readings in thecluster in accordance with some implementations. In some instances, thesurvey data is entered and reviewed by the person whose blood glucose isbeing monitored. In other instances, another user (such as a care giveror relative) enters the data, or a portion of the data.

In some implementations, the hypoglycemic events listed in FIG. 5C aresorted and displayed in reverse chronological order (most recent toleast recent within the last two weeks). Though not shown in 5C, a “loadmore” button can be displayed. When clicked, more historicalhypoglycemic events are displayed in the same reverse chronologicalorder. In FIG. 5C, the date and time of each hypoglycemic event isdisplayed along with the BG value. If the hypoglycemic event is made upof multiple readings, the date and time and value of the occurrence ofthe first hypo reading in the event is displayed, with an icon thatdepicts the number of hypo readings in the hypo event.

In some implementations, if a survey has been completed for a singlehypoglycemic event, three icons 510 are displayed across the cell in theuser interface. The three icons 510 represent symptoms, treatment, andcauses. In some implementations, the number of displayed icons islimited by available space in the user interface (e.g., showing only oneicon for each of the categories). Selecting the icons 510 or other iconsassociated with the completed hypoglycemic event entry, a summary of thehypoglycemic event is displayed. An exemplary summary user interface isshown in FIG. 5J.

In some implementations, if the screen size is small, one icon is usedto indicate a survey has been filled out. If a hypo survey has beenpartially completed, a different indicator is displayed in the rowcorresponds to the hypoglycemic event entry in the user interface.Selecting the indicator, the next screen to be completed in the hyposurvey is displayed. In some implementations, if the hypoglycemic eventis made up of multiple hypoglycemic readings, a window is displayed thatshows each reading in the event. In some implementations, this windowincludes a Start button. Tapping or clicking the Start button begins thehypo survey.

Referring back to FIG. 4, once the client-side modules 106 receivesinstructions from the patient 122 to start the survey entries, theclient-side modules 106 provide (408) the hypo survey associated withthe hypoglycemic event. The client-side modules 106 further obtain (410)user feedback from the hypo survey and determine (412) whether a severehypoglycemic event has occurred. The feedback includes (410) symptoms,causes, and/or treatment. The user feedback can be stored in the clientdatabase 238 on the client devices 102. In some implementations, theclient database 238 includes information such as:

-   -   What symptoms did the patient feel?    -   What caused the patient to feel hypo (perceived cause)?    -   How did the patient treat the hypoglycemic event (treatment)?    -   Did the patient require assistance (severe hypo)?

The information listed above (symptoms, causes and treatments) can bestored separately (e.g., in separate tables in the client database 238)in some implementations. When requested, the client-side modules 106retrieve the data stored in the client database 238, combine the data,and provide (414) one or more hypo reports that include at least asubset of the information listed above for display on the client devices102. The hypo report includes at least a subset of user feedback fromthe hypo survey. An exemplary hypo report is shown in FIG. 5C inresponse to the patient's 122 selection of View Hypos, as shown in FIG.5A. In addition to the hypo report, the client-side modules 106 provide(416) a summary comprising hypoglycemic event data entries, such assymptoms, causes, and treatments provided by the hypo survey, asillustrated in FIG. 5J.

FIGS. 5D-5J illustrate user interfaces for an exemplary survey and asummary of the exemplary survey. For example, as shown in FIG. 5D, areading display 512 of 46 mg/dL indicates a hypoglycemic event hasoccurred at 3:21 PM on Apr. 18, 2012. In some implementations, the firstsection of the hypo survey is to enter the symptoms. In someimplementations, to facilitate the entries (e.g., if this is thepatient's 122 first time filling out a hypo survey), the patient 122 isshown a pop-up that includes a definition for each symptom. The patient122 can close the pop-up and begin filling out the hypo survey.

Once the patient 122 begins filling out the hypo survey, the client-sidemodules 106 receive the patient 122 selection of one or more symptomsthat apply for that hypoglycemia event 512 and display the selection. Insome implementations, the list of symptoms is arranged from most toleast common and includes a predetermined number of symptoms (e.g.,approximately 20). In some implementations, the order of symptoms can becustomized and machine-learned so that the symptoms most common to theindividual patient 122 are displayed at the beginning of the list. Insome implementations, icons 514 can turn different color and/or shadeetc. when selected. Deselecting the icons 514 can restore the colorand/or shade. An exemplary list of symptoms that can be displayed asicons includes trembling 514-1, nervous 514-2, heart pounding, sweating,fatigue, unusual hunger, discomfort in legs, feeling cold, numb lips,depressed, hard to focus, light headed, blurred vision, headache, queasystomach, slurred speech, difficulty walking, difficulty driving, nosymptoms, and other.

Turning to FIG. 5E, in some implementations, an instructive tool tip 515regarding symptoms can be displayed to help the patient 122 determinethe type of information entered in the symptoms user interface. In someimplementations, if a patient 122 does not see his/her symptom listed,the patient 122 can create a custom symptom. For example, in someimplementations, the client-side modules 106 display a section labeled“Anything else you want to add.” In response to selecting this section,the client-side modules 106 display a text box for the patient 122 toenter the symptom(s). Upon completion, the client-modules 106 receive anindication from the patient 122 (e.g., the patient 122 clicks a Donebutton) and close the text box.

Referring back to FIG. 5D, once the symptoms are selected, the patient122 can tap or click a Next button 518 to save the symptom(s) and moveon to the next section, causes. In some instances, the patient 122 maynot get to the end (e.g., may not click the Quit button 516). Since eachincremental set of data is important, clicking the Next button 518 savesthe incremental set of data to the client database 238.

In some implementations, the second section of the hypo survey is toenter the causes. For example, as shown in FIG. 5F, the client-sidemodules 106 display a user interface for the patient 122 to enter thecauses for the hypoglycemic event that occurred at 3:21 PM on Apr. 18,2012. In some implementations, to facilitate the entries (e.g., if thisis the patient's 122 first time filling out the hypo survey), theclient-side modules 106 display a pop-up to the patient 122 thatincludes the definition of each cause. The patient 122 can close thepop-up and continue filling out the hypo survey. An exemplary list ofcauses that are displayed as icons includes: excess insulin, excessmedication, unplanned activity, exercise, delayed meal, incorrect carbcalc (carbohydrate calculation by the patient), schedule change,alcohol, don't know, and other.

In some implementations, the client-side modules 106 receive the patient122 selection of one or more causes that apply for that hypoglycemiaevent 512 and display the selection. In some implementations, an icon524 can turn different color and/or shape etc. when selected. Turning toFIG. 5G, in some implementations, an instructive tool tip 529 regardingcauses can be displayed to help the patient 122 determine the type ofinformation entered in the causes user interface. Referring back to FIG.5F, in some implementations, the client-side modules 106 display theinstructive tool tip in response to the patient 112 selection of a tooltip icon 520.

In some implementations, if a patient 122 does not see his/her causelisted, the patient 122 can create a custom cause. For example, in someimplementations, the client-side modules 106 display a section labeled“Other” 522. In response to selecting the other section 522, theclient-side modules 106 display a text box for the patient 122 to enterthe cause(s). Upon completion, the client-modules 106 receive anindication from the patient 122 (e.g., the patient 122 clicks a Donebutton) and close the text box.

Once the causes are selected, the patient 122 can click the Next button528 to save the cause(s) and move on to the next section (treatments).If the patient 122 wants to edit the symptoms entered previously, thepatient 122 can click the Back button 526 to return to the symptomsscreen.

In some implementations, the third section of the hypo survey is toenter the treatments. For example, as shown in FIG. 5H, the client-sidemodules 106 display a user interface for the patient 122 to enter thetreatments for the hypoglycemic event that occurred at 3:21 PM on Apr.18, 2012. In some implementations, to facilitate the entries (e.g., ifthis is the patient's 122 first time filling out the hypo survey), theclient-side modules 106 display a pop-up to the patient 122 thatincludes the definition of each treatment. The patient 122 can close thepop-up and continue filling out the hypo survey.

In some implementations, the client-side modules 106 receive the patient122 selection of one or more treatments that apply for that hypoglycemiaevent 512 and display the selection. In some implementations, an icon534 can turn different color and/or shape etc. when selected. Anexemplary list of treatments that can be displayed as icons includes:juice, food, glucose tablet, glucose gel, and other. If the personrequired assistance to treat the hypo event, an exemplary list oftreatments for severe hypoglycemic events includes: glucagon injection,EMT assistance, and Emergency Room.

For each treatment selected, the client-side modules 106 can display apop-up window for the patient 122 to provide more details. For example,the quantity of the treatment such as 15 g of sugar vs. 30 g of sugarand/or clinical implication of whether the patient 122 is over treatingin the hypoglycemic event can be added as treatment details. As shown inFIG. 5H, in response to the patient's 122 selection of the glucosetablet icon 534, the client-side modules 106 display a pop-up window532. In the pop-up window 532, the number of glucose tablets can beentered. Once the patient 122 fills out more details of the treatment inthe pop-up window 532, the patient 122 can click Save to return to thetreatment page illustrated in FIG. 5H.

Turning to FIG. 5I, in some implementations, an instructive tool tip 535regarding treatments is displayed to help the patient 122 determine thetype of information to enter in the treatments user interface. Referringback to FIG. 5H, in some implementations, the client-side modules 106display the instructive tool tip 535 in response to patient selection ofa tool tip icon 537.

In some implementations, if a patient 122 does not see his/her treatmentlisted, the patient 122 can create a custom cause. For example, in someimplementations, the client-side modules 106 display a section labeled“Other” 534. In response to selecting the section 534, the client-sidemodules 106 display a text box for the patient 122 to enter thetreatment(s). Upon completion, the client-modules 106 receive anindication from the patient 122 (e.g., the patient 122 clicks a Donebutton) and close the text box.

In some implementations, the client-side modules 106 also display anon/off switch 536 to allow the patient 122 specify if the patient 122required medical assistance for the particular hypoglycemic event. Insome implementations, the client-side modules set and display No asdefault to indicate the patient 122 did not require medical assistance.The patient 122 can toggle the on/off switch 536 to indicate that thepatient 122 did require assistance. A hypoglycemic event that neededassistance is a severe hypoglycemic event. In response to receiving theyes selection the switch 536, the client-side module 106 can furtherprovide an entry field to allow the patient 122 specific the type ofassistance provided. In some implementations, the user entering the typeof assistance provided may be different from the patient 122, for whomthe readings were taken. Once the treatments are selected, the patient122 can click the Next button 538 to save the treatment(s) and see asummary of the hypo survey. If the patient 122 wants to edit thesymptoms and causes entered previously, the patient 122 can click theBack button 539 to return to the symptoms and/or causes screen.

In some implementations, the final section of the hypo survey is asummary. The client-side module 106 retrieves the symptoms, causes, andtreatments stored in the client database 238 and displays the survey asshown in FIG. 5J. To edit a specific section of the hypo survey, thepatient 122 can click edit icons 540. In response to receiving the editselection input, the client-modules 106 displays the correspondingsection of the hypo survey for editing. When the patient 122 issatisfied with the survey entries, the patient 122 can click the Savebutton 548.

As described above with respect to FIGS. 5D-5J, the survey can includethe following sections:

-   -   What symptoms did you feel (FIGS. 5D-5E)?    -   What caused you to feel hypoglycemic (e.g., perceived causes,        FIGS. 5F-5G)?    -   How did you treat your hypoglycemic event (e.g., treatments, did        you require assistance, FIGS. 5H-5I)?

The client-modules 106 obtain user feedback from the hypo survey andstore the data in the client database 238. In some implementations, eachof the sections in the hypo survey is displayed in a separate userinterface, e.g. symptoms (FIG. 5D), causes (FIG. 5F), and treatments(FIG. 5H). For each of the above sections, the patient 122 can choosefrom stock answers (e.g., the symptoms icons 514 in FIG. 5D, the causeicon 524 in FIG. 5F, and the treatment icon 534 in FIG. 5H) as well asenter free form text. In some implementations, since the hypoglycemicevent data can be stored in the client database 238, the user interfacesas shown in FIG. 5A-5J can be displayed without the client device 102being connected to the communications network 104. In someimplementations, the user interfaces as shown in FIG. 5A-5J can bedisplayed after other synchronization prompts, e.g., sync successful.

It should be understood that the particular order in which theoperations in FIG. 4 have been described is merely exemplary and is notintended to indicate that the described order is the only order in whichthe operations could be performed. One of ordinary skill in the artwould recognize various ways to reorder the operations described herein.For brevity, these details are not repeated here.

The foregoing description of the user interfaces with respect to FIGS.5D-5J, for purpose of explanation, has been described with reference tospecific embodiments. However, the illustrative discussions above arenot intended to be exhaustive or to limit the invention to the preciseforms disclosed. Many modifications and variations are possible in viewof the above teachings. For example, in some implementations, theclient-side modules 106 can display a None field within each question(e.g., no symptoms, no treatment, don't know cause etc.) In anotherimplementation, a patient 122 can fill out a hypo survey independent ofa reading value. The client-side modules 106 can display a Quick Addscreen or allow the patient 122 to choose “Feeling Hypo” for easieraccess. In addition, the client-side modules 106 can provide searchfunctions so that the patients 122 can easily find the hypoglycemicevents that they have not responded to in the history list or reportslist. In yet another example, the questions in the survey as shown inFIGS. 5A-5I can be customizable and configured. The illustratedimplementations were chosen and described in order to best explain theprinciples of the invention and its practical applications, to therebyenable others skilled in the art to best use the invention and variousdescribed embodiments with various modifications as are suited to theparticular use contemplated.

In some implementations, the client-side modules 106 transmit thehypoglycemia data to a server 108. The data can be uploaded to theserver 108 automatically or upon request in accordance with someimplementations. In addition to upload, the server 108 can receive thedata via other methods, such as by email, fax, scan of print, and/ormanual entries, among others. Utilizing (418) the hypoglycemic eventinformation, such as the information one or more hypo reports and aplurality of blood glucose readings, the server 108 produces one or moreglucose data reports. The generated reports can then be provided (420)to healthcare providers (e.g., doctors and nurses) and/or payers (e.g.,insurance companies). FIGS. 5K-5M illustrate examples of glucose datareports.

FIG. 5K illustrates a hypo awareness grid 550 that can be displayed on aclient device 102 or on a device 130. In some implementations, theserver 108 receives a request from the client-side modules 106 or thedevice 130 to access the hypoglycemic awareness grid. In someimplementations, the access uses a web application hosted by the server108. Upon receiving the request, the server 108 retrieves the data fromthe hypoglycemic database 110, and transmits the results to therequestor for display on the client device 102 or the device 130. Insome implementations, the results include analysis of the hypo eventdata, including identified patterns.

For example, in FIG. 5K, the top of the page displays a date picker 552that allows the user to select the date interval in which to displayhistorical hypoglycemic events. The default time frame 554 is 30 days insome implementations. Below the data picker 552, a legend 556representing the number of symptom and BG level combination occurrencesis displayed. One occurrence may be in a lighter color and/or shade thansix plus occurrences in some implementations. Next to the legend 556,the number of hypo surveys filled out relative to the number ofhypoglycemic events within the selected date interval 552 is displayed.In FIG. 5K, there were eight hypoglycemic events detected by the clientdevice 102. Among the eight events, six of them have hypo surveys filledout.

The hypo awareness view displays a grid of hypoglycemic events thatcorrespond to symptoms reported by the user 122. The static y-axiscorresponds to BG values. Increments (e.g., of two) are displayed, fromtop to bottom, e.g., starting at 70 mg/dL and ending at 30 mg/dL. InFIG. 5K, the last entry listed is “<30 mg/dL”. The x-axis displays alist of individual symptoms that are categorized from autonomic tocognitive. Every stock symptom that was selected by the user during thesurvey is displayed in the x-axis. The last entry listed in symptoms is“No Symptoms”. In some implementations, the symptoms listed on x-axisare sorted and displayed from mild to severe.

In some implementations, the hypo grid is divided into quadrants. Forexample, in FIG. 5K, quadrants 560 are be defined by: 70-50, autonomicsymptoms; 50-30 autonomic symptoms; 70-50, cognitive symptoms; and 50-30cognitive symptoms. Examples of autonomic symptoms of hypoglycemicevents are trembling, nervous, heart pounding, sweating, and unusualhunger. Cognitive symptoms are due to a shortage of glucose in the brainthat affects the function of neurons. Examples of cognitive symptoms arefatigue, discomfort in legs, feeling cold, numb lips, depressed, hard tofocus, light-headed, blurred vision, headache, queasy stomach, slurredspeech, difficulty walking, and difficulty driving.

In FIG. 5K, if a survey as shown in FIGS. 5A-5J has been filled out fora hypoglycemic event, an indicator (e.g., a square 558) is recorded inone or more cells that correspond to the BG values and appropriatesymptoms. If the same (BG level, symptom) pair occurred for multiplehypo events, some implementations shade the square 558 according to thelegend 556, with the number of occurrences listed in the square. Thecolor or shading of the square 558 corresponds to the legend 556. Thehypo awareness report as shown in FIG. 5K directly maps low glucosereadings with associated individual-specific symptoms. This datavisualization allows providers, such as clinicians, at a glance, todetermine if patients have hypoglycemia unawareness. This datavisualization also helps to raise patients' hypoglycemia awareness.

In some implementations, in response to detecting a hovering event overa square, a tooltip is displayed corresponding to the symptom. In someimplementations, a black box with a symptom description is displayedaround the square when hovering. Also not shown in FIG. 5K, in someimplementations, a composite score based on frequency, severity, anddegree of unawareness of the hypoglycemia can be calculated anddisplayed.

FIG. 5L illustrates a hypo patterns grid 565 that can be displayed on aclient device 102 or a device 130. Similar to the hypo awareness grid550 in FIG. 5K, the top of the page displays a date picker 566 thatallows the user to select the timeframe in which to display historicalhypoglycemic events. Though not shown in FIG. 5L, in someimplementations, the user can select the month to view by tapping leftor right arrows next to the month listed. The first time the page isloaded, in some implementations, the current month is displayed. In someimplementations, the days that do not fall in the selected timeframe canbe grayed out. In some implementations, the occurrence of hypoglycemicevents can still be graphically depicted in the hypoglycemic patternsgrids 565 in the days before and after the selected month(s). Inaddition to the data picker 566, also similar to hypo awareness grid 550in FIG. 5K, the number of hypo surveys filled out relative to the numberof hypoglycemic events happened within the selected date interval isdisplayed.

In the hypo patterns grid 565, a legend 568 representing time periods ina day. Each time period can be displayed in a different color and/orshade etc. For example, in FIG. 5L, each day is divided to four timeperiods: 12 AM-6 AM, 6 AM-12 PM, 12 PM-6 PM, 6 PM-12 AM. The time period12 AM to 6 AM is in a different color and/or shade from other timeperiods.

The hypo patterns grid 565 displays a pattern of hypoglycemic eventsoccurrences during different time periods in a day. Each row in thecalendar view represents a full week. If a hypoglycemic event occurredduring one of the time periods, the portion of the day block thatcorresponds to the time periods is colored and/or shaded. If multiplehypoglycemic events occurred on the same day in the same time period,the coloring and/or shading can be the same as if one hypoglycemic eventoccurred in that timeslot on that day. The indicators 570 are coloredand/or shaded according to the legend 568.

In some implementations, the hypo patterns report 565 maps hypoglycemicevents by time of day and day of the week. It helps differentiatebetween random hypoglycemia and more predictable hypoglycemic eventsthat are linked to daily and weekly life routines and habits. Forexample, the indicators 570-1 and 570-4 are the same color and/or shadein FIG. 5L, representing at least one hypoglycemic event happened onSaturday Aug. 2, 2014 between 6 PM and 12 AM and at least onehypoglycemic event happened on Saturday Aug. 9, 2014 between 6 PM and 12AM. Similarly, the indicators 570-2 and 570-6 are the same color and/orshade in FIG. 5L, representing at least one hypoglycemic event happenedon Wednesday Aug. 6, 2014 between 6 PM and 12 AM and at least onehypoglycemic event happened on Wednesday Aug. 13, 2014 between 6 PM and12 AM. A pattern may be drawn to establish linkages between predictableweekend and/or Wednesday afternoon hypoglycemic events and the weeklylife routines and habits. On the other hand, indicators 570-3, 570-5,and 570-7 are of different colors and/or shades and displayed indifferent date blocks. These indicators may help differentiate randomhypoglycemic events from the more predictable hypoglycemic events markedby indicators 570-1, 570-4, 570-2, and 570-6.

FIG. 5M illustrates a hypo day report 575 that can be displayed on aclient device 102 or a device 130. The hypo day report 575 displayscontextual information from each hypoglycemic event, plus thecorresponding data for 12 hours before and after the episode in someimplementations. This report provides detailed information around eachhypoglycemic event, thereby enhancing clinical decision-making. It alsoturns events into teachable moments, improving patients' insight intohow to prevent and treat hypoglycemia. Similar to the hypo awarenessgrid 550 in FIG. 5K and the hypo patterns 565 in FIG. 5L, the top of thepage displays a date picker 576 that allows the user to select thetimeframe in which to display historical hypoglycemic events. Alsosimilar to hypo awareness grid 550 in FIG. 5K, the default time frame is30 days in some implementations.

The list of hypoglycemic events in the hypo day report 575 can be sortedand displayed in different orders. In some implementations, thehypoglycemic events can be shorted by BG values. In response to aselection of BG List button 578, the hypo survey results can be orderedfrom lowest to highest glucose reading. In response to a selection ofTime of Day button 580, the hypo survey results can be ordered frommorning to evening, bucketed into different periods of the day. In someimplementations, the ordering by time of day is set as the default.

Below the BG List 578 and Time of Day 580, the hypoglycemic eventsdetected within the selected timeframe are displayed. For eachhypoglycemic event, the BG value, time of the event, and user feedbackfrom the survey are displayed. In some implementations, severe hypoevents which required assistance are called out and flagged in thehypoglycemic day report 575. In some implementations, if the user hasnot filled out a survey, a message is displayed across the user feedbackcolumns to remind the user to fill out the survey. Clicking on themessage can take the user to the survey user interfaces as shown inFIGS. 5A-5J.

In some implementations, above each day where at least one hypoglycemicevent has been detected, an indicator 588 representing the time periodin a day of the hypoglycemic event is displayed. In someimplementations, the color and/or shading of the indicator 588 isconsistent with the legend 568 displayed in the hypo patterns grid 565,as shown in FIG. 5L. In addition to using different colors and/orshadings representing different time periods in a day of thehypoglycemic event, in some implementations, the BG value 587 candisplayed using the color and/or shading consistent with the legend 556in the hypo awareness grid 550, as shown in FIG. 5K. For example, ifmultiple symptoms occurred for the same range of BG values, the BG value587 can be colored and/or shaded according to the legend 556.

For each hypoglycemic event, a graph icon 582 is displayed. By clickingon the graph icon 582, a time of day graph 584 appears. While the timeof day graph 584 is displayed, clicking on the graph icon 582 can hidethe time of day graph 584. The time of day graph 584 is a 24 hour graphthat has hypo hour in the middle of the line in accordance with someimplementations. The graph 584 has an x-axis that spans 24 hours. Thex-axis starts 12 hours before the time of the hypoglycemic event (e.g.,the timestamp of first reading for the hypoglycemic event). The y-axisauto-adjusts to fit the data present in the 24-hour interval. The usercan set a lower limit BG value after meal and an upper limit BG valuebefore meal. Both limits are shaded on the graph 584. The linerepresents the before meal upper limit set by the user. The tick markson the x-axis display every 2 hours on the hour. Below each end of thex-axis the day of week and date is displayed. Each BG value reading isrepresented by an individual data point. The BG values 586 are coloredbased on whether they fall below, within or above the user's set targetranges. Readings tagged as before meal are considered to be within rangeif they fall within the lower limit and upper limit. In someimplementations, though not shown in FIG. 5M, a line is used to connectthe BG values 586.

In some implementations, the reports described above with respect toFIGS. 5K-5M can be requested by patients, healthcare providers, orpayers. In some implementations, an access control module 338 on theserver 108 can authenticate and authorize the request before retrievethe data from the hypoglycemic database 110, generate reports based onthe data, and transmitting the reports. For example, a patient 122 maywant to access reports generated based on his blood glucose readingsuploaded to the server 108. The client-side modules 106 on a clientdevice 102 used by the patient 122 obtains the patient's 122 identifierand sends the credentials to the server 108 for authentication andauthorization. The access control module 338 compares the receivedcredentials with the information stored in the user database 342 forauthentication and authorization. Upon successful authentication andauthorization, the server 108 transmits the requested reports generatedbased on the patients' 122 uploaded readings to the client device 102for display. In another example, the patient 122 may upload some of hisreadings to share with a doctor 132. The modules on the device 130 usedby the doctor 130 receive the doctor's 132 identifier and sends thecredentials to the server 108 for authentication and authorization. Uponsuccessful authentication and authorization, the server 108 transmitsthe requested reports generated based on the patients' 122 sharedreadings to the device 130 for display. In yet another example, a payer(e.g., an insurance company) may want to disable the reports for aspecific provider 132 that is not part of the payer's network. When thespecific provider 132 attempts to access the reports, without successfulauthentication and authorization, the server 108 does not transmit therequested reports generated based on the patients' 122 uploaded readingsto the device 130 for display.

FIGS. 6A-6F provide a flow diagram of a method 600 for receivinghypoglycemic event data, analyzing the data, and providing reports basedon the data in accordance with some implementations. Various operationsof the method 600 are performed (602) at a computing device, such as theserver system 108 shown in FIG. 3 and/or the client device 102 shown inFIG. 2 and/or the device 130, having one or more processors (e.g., theCPU 202 in client device 102 and/or the CPU 302 in server 108), adisplay device (e.g., the display 206 as part of the client device 102and/or a display as part of the device 130), and memory (e.g., thememory 212 in client device 102 and/or the memory in server 108) storingone or more programs configured for execution by the one or moreprocessors.

The computing device first receives (604) a plurality of blood glucosereadings for a person (e.g., the patient 122). Each reading includes: ablood glucose value and a timestamp (e.g., date and time) that indicateswhen the respective reading was taken. In some implementations, theperson (e.g., the patient 122 or an assistant) is prompted (606) toprovide information only for hypoglycemic events that are less than twoweeks old. In some implementations, a plurality of blood glucosereadings that are below the predefined hypoglycemic event thresholdcomprise (608) a single hypoglycemic event when the timestamps of theblood glucose readings are within a two hour time period.

Upon receiving the readings, the computing device compares (610) eachblood glucose reading of the plurality to a predefined hypoglycemicevent threshold and identifies a hypoglycemic event when a respectiveblood glucose reading is below the predefined hypoglycemic eventthreshold. In some implementations, the predefined hypoglycemicthreshold is (612) defined as a fixed value (e.g., 70 mg/dL), is set bythe person (e.g., the patient 122), or is set by a doctor. In someimplementations, each blood glucose reading that is below the predefinedhypoglycemic event threshold is (614) identified as a distincthypoglycemic event.

Having identified the hypoglycemic event, the computing device prompts(616) the person (e.g., the patient 122 or an assistant) to provideinformation associated with each hypoglycemic event for at least asubset of the identified hypoglycemic events. In some implementations,the information requested includes one or more of: symptoms associatedwith the respective hypoglycemic event; perceived causes of therespective hypoglycemic event; and treatment for the respectivehypoglycemic event. In response to the prompting, the computing deviceobtains (630) feedback from the person (e.g., the patient 122) about theidentified hypoglycemic events uses a graphical user interface on thedisplay device. In some implementations, the obtained feedback includes(632): feedback regarding symptoms; feedback regarding causes; andfeedback regarding treatment.

For example, as shown in FIG. 5D, the computing device displays (618) aplurality of hypoglycemic event symptom icons and records (620) userselection of one or more of the plurality of hypoglycemic event symptomicons (e.g., the icons 514-1 and 514-2). In FIG. 5D, the obtainedfeedback includes symptoms such as trembling as represented by icon514-1 and nervous as represented by icon 514-2. In another example, asshown in FIG. 5F, the computing device displays (622) a plurality ofhypoglycemic event cause icons and records (624) user selection of oneor more of the plurality of hypoglycemic event cause icons (e.g., theicon 524). In FIG. 5F, the obtained feedback include a cause of excessmedication as represented by icon 524. In yet another example, as shownin FIG. 5H, the computing device displays (626) a plurality ofhypoglycemic event treatment icons and records (628) user selection ofone or more of the plurality of hypoglycemic event treatment icons(e.g., the icon 534). In FIG. 5H, the obtained feedback includes atreatment of glucose tablet as represented by icon 534-1.

In some implementations, the feedback gathered is stored in the clientdevice 102 (e.g., the client database 238) and/or the server 108 (e.g.,the hypoglycemic event database 110). In response to requests from theclient device 102 and/or the device 130, the client device 102 and/orthe server 108 provide (634) a report on the display device (e.g., onthe display 206 as part of the client device 102 or a display as part ofthe device 130) that includes at least a subset of the obtainedfeedback. In some implementations, the provided report includes (636) ahypo awareness grid (FIG. 5K). One axis of the hypo awareness grid showsblood glucose level and a second axis of the grid shows reportedsymptoms. Each entry in the grid indicates how many hypoglycemic eventshad a specific (glucose level, symptom) pair. In some implementations,the provided report includes (638) a graphical presentation ofinformation regarding blood glucose levels before and after one or morehypoglycemic events (e.g., FIG. 5L and FIG. 5M). In accordance with someimplementations, the provided report includes (640) one or morerecommended changes to activities of the person.

In some implementations, the glucose data report module 234 on theclient device 102 and/or the glucose data report module 334 furtheranalyze (642) the hypoglycemic events and the obtained feedback toidentify one or more patterns of hypoglycemic events and include (648)the identified patterns of hypoglycemic events in the provided report(e.g., FIGS. 5K-5M). In some implementations, the identified patternsinclude (644) a correlation between hypoglycemic events and time of dayor day or week (e.g., FIG. 5L and FIG. 5M). In some otherimplementations, the identified patterns indicate (646) that the personis unaware when low blood glucose levels are occurring (e.g., FIG. 5K).

In some implementations, based on the feedback and the readings, theclient device 102 and/or the server 108 determine (650) that a severehypoglycemic event occurred when the person indicates that assistancewas required. The assistance information can be gathered by the clientdevice 102 as shown in FIG. 5H. The severe hypoglycemic event can beindicated in the patterns displayed and reports generated.

The various hypoglycemic event analysis operations of the method 600described above can be performed on the server system 108 shown in FIG.3 and/or the client device 102 shown in FIG. 2. As explained above withrespect to FIG. 2 and FIG. 3, the functionality described in FIGS. 2 and3 may be implemented either on the client device 102, on the server 108,or both. Various implementations allocate functionality between theclient device 102 and the server 108 in various ways. In someimplementations, the allocation of functionality is configurable basedon individual devices. For example, in some implementations, the clientdevice 102 receives blood glucose readings from the meter 120 andobtains feedback from the patient 122. The client device then transmits(652) the received blood glucose readings and obtained feedback to asecond device (e.g., the server 108) to identify one or more patterns ofhypoglycemic events. The identified patterns can then be accessed bydoctors and/or nurses and/or insurance companies.

FIGS. 7A-7B illustrate a flow diagram of a method 700 for managing lowblood glucose levels, in accordance with some implementations. Variousoperations of the method 700 are performed (702) at a computing device,such as a server system 108 as shown in FIG. 3 and/or a client device102 shown in FIG. 2 and/or a device 130. The computing device has one ormore processors (e.g., the CPU 202 in client device 102 and/or the CPU302 in server 108) and memory (e.g., the memory 212 in client device 102and/or the memory in server 108) storing one or more programs configuredfor execution by the one or more processors.

The computing device first receives (704) a plurality of blood glucosereadings for a person (e.g., the patient 122). The computing device thenfor at least a subset of the blood glucose readings, receives (706)contemporaneous information about the person that specifies:hypoglycemic symptoms associated with the respective blood glucosereading, perceived causes of hypoglycemia at the time of the respectiveblood glucose reading, and treatment for hypoglycemia at the time of therespective blood glucose reading. Based on the information, thecomputing device then determines (708) that one or more of the bloodglucose readings represent hypoglycemic events when a respective bloodglucose reading is below a predefined hypoglycemic event threshold. Thecomputing device also analyzes (710) the hypoglycemic events and thecontemporaneous information to identify one or more patterns ofhypoglycemic events and provides (716) a report that includes theidentified patterns of hypoglycemic events and at least a subset of thecontemporaneous information.

For example, as described above with respect to FIG. 1, the readings areobtained from the meter 120 by the client device 102 after blood sampleswere supplied to the meter 120. In some implementations, the readingsare subsequently uploaded to the server 108 from the client device 102via the communication network 104. In some implementations, each readingincludes a blood glucose value and a timestamp (e.g., date and time)that indicates when the respective reading was taken. Based on thereadings, the computing device determines if one or more hypoglycemicevents has occurred and prompts the user to fill out the survey as shownin FIGS. 5A-5J in near real time. The computing device also analyzes thehypoglycemic events, identifies patterns and provides reports as shownin FIGS. 5K-5M.

In some implementations, the provided report includes (718) a hypoawareness grid (FIG. 5K). One axis of the hypo awareness grid showsblood glucose level and a second axis of the grid shows reportedsymptoms. Each entry in the grid indicates how many hypoglycemic eventshad a specific (glucose level, symptom) pair. In some implementations,the provided report includes (720) a graphical presentation ofinformation regarding blood glucose levels before and after one or morehypoglycemic events (e.g., FIG. 5L and FIG. 5M). In accordance with someimplementations, the provided report includes (722) one or morerecommended changes to activities of the person. The recommended changestypically include one or more of: changes to exercise, changes toeating, and/or changes to taking medication.

In some implementations, the identified patterns include (712) acorrelation between hypoglycemic events and time of day or day or week(e.g., FIG. 5L and FIG. 5M). In some other implementations, theidentified patterns indicate (714) that the person is unaware when lowblood glucose levels are occurring (e.g., FIG. 5K).

In some implementations, based on the feedback and the readings, thecomputing device determines (724) that a severe hypoglycemic eventoccurred when the person indicates that assistance was required. Theassistance information can be gathered by the client device 102 as shownin FIG. 5H. The severe hypoglycemic event can be indicated in thepatterns displayed and reports generated.

It will be understood that, although the terms first, second, etc. maybe used herein to describe various elements, these elements should notbe limited by these terms. These terms are only used to distinguish oneelement from another. For example, a first element could be termed asecond element, and, similarly, a second element could be termed a firstelement, without changing the meaning of the description, so long as alloccurrences of the first element are renamed consistently and alloccurrences of the second element are renamed consistently. The firstelement and the second element are both elements, but they are not thesame element.

As used in the description of the implementations and the appendedclaims, the singular forms “a,” “an,” and “the” are intended to includethe plural forms as well, unless the context clearly indicatesotherwise. It will also be understood that the term “and/or” as usedherein refers to and encompasses any and all possible combinations ofone or more of the associated listed items. It will be furtherunderstood that the terms “comprises” and/or “comprising,” as well asthe terms “includes” and/or “including” when used in this specification,specify the presence of stated features, integers, steps, operations,elements, and/or components, but do not preclude the presence oraddition of one or more other features, integers, steps, operations,elements, components, and/or groups thereof.

As used herein, the term “if” may be construed to mean “when” or “upon”or “in response to,” depending on the context. Similarly, the phrase “ifit is determined” or “if (a stated condition or event]) is detected” maybe construed to mean “upon determining” or “in response to determining”or “upon detecting (the stated condition or event)” or “in response todetecting (the stated condition or event),” depending on the context.

The foregoing description, for purpose of explanation, has beendescribed with reference to specific implementations. However, theillustrative discussions above are not intended to be exhaustive or tolimit the invention to the precise forms disclosed. Many modificationsand variations are possible in view of the above teachings. Theimplementations were chosen and described in order to best explain theprinciples of the invention and its practical applications, to therebyenable others skilled in the art to best utilize the invention andvarious implementations with various modifications as are suited to theparticular use contemplated.

What is claimed is:
 1. A method for understanding and managing low bloodglucose levels, comprising: at a computer system having one or moreprocessors, a display device, and memory storing one or more programsconfigured for execution by the one or more processors: receiving aplurality of blood glucose readings for a person, wherein each readingincludes: a blood glucose value; and a timestamp indicating when therespective reading was taken; comparing each blood glucose reading ofthe plurality to a predefined hypoglycemic event threshold, andidentifying a hypoglycemic event when the respective blood glucosereading is below the predefined hypoglycemic event threshold; for atleast a subset of the identified hypoglycemic events, prompting theperson to provide information associated with each hypoglycemic eventusing a graphical user interface on the display device, the informationincluding one or more of: symptoms associated with the respectivehypoglycemic event; perceived causes of the respective hypoglycemicevent; and treatment for the respective hypoglycemic event; in responseto the prompting, obtaining feedback from the person about theidentified hypoglycemic events using the graphical user interface on thedisplay device, including recording user selection of one or more of aplurality of hypoglycemic event icons displayed in the graphical userinterface; and providing a report on the display device that includes atleast a subset of the obtained feedback.
 2. The method of claim 1,wherein the obtained feedback includes: information regarding thesymptoms; information regarding the causes; and information regardingthe treatment.
 3. The method of claim 1, further comprising determiningthat a severe hypoglycemic event occurred when the person indicates thatassistance was required.
 4. The method of claim 1, wherein each bloodglucose reading that is below the predefined hypoglycemic eventthreshold is identified as a distinct hypoglycemic event.
 5. The methodof claim 1, wherein a plurality of blood glucose readings that are belowthe predefined hypoglycemic event threshold comprise a singlehypoglycemic event when the timestamps of the blood glucose readings arewithin a two hour time period.
 6. The method of claim 1, wherein theprovided report includes a hypo awareness grid, including a first axisthat shows blood glucose level, a second axis that shows reportedsymptoms, and entries in the grid indicating how many hypoglycemicevents had a specific (glucose level, symptom) pair.
 7. The method ofclaim 1, wherein the provided report includes a graphical presentationof information regarding the blood glucose levels before and after thehypoglycemic events.
 8. The method of claim 1, further comprising:transmitting the received plurality of blood glucose readings and theobtained feedback to a second computing device to identify one or morepatterns of hypoglycemic events.
 9. The method of claim 1, furthercomprising: analyzing the identified hypoglycemic events and theobtained feedback to identify one or more patterns of the hypoglycemicevents; and including the identified one or more patterns ofhypoglycemic events in the provided report.
 10. The method of claim 9,wherein the identified one or more patterns of hypoglycemic eventsinclude a correlation between hypoglycemic events and time of day or dayof week.
 11. The method of claim 9, wherein the identified one or morepatterns of hypoglycemic events indicate that the person is unaware whenlow blood glucose levels are occurring.
 12. The method of claim 1,wherein the provided report includes one or more recommended changes toactivities of the person, and wherein the one or more recommendedchanges are associated with exercising, eating, or taking medication.13. The method of claim 1, wherein the graphical user interface includesthe plurality of hypoglycemic event icons, each hypoglycemic event iconincluding an indicator that shows how commonly the respectivehypoglycemic event icon is selected by the person using (i) a numeral,(ii) icon shading, and/or (iii) icon coloring.
 14. A computer system,comprising: one or more processors; a display device; and memory storingone or more programs configured for execution by the one or moreprocessors, the one or more programs including instructions for:receiving a plurality of blood glucose readings for a person, whereineach reading includes: a blood glucose value; and a timestamp indicatingwhen the respective reading was taken; comparing each blood glucosereading of the plurality to a predefined hypoglycemic event threshold,and identifying a hypoglycemic event when the respective blood glucosereading is below the predefined hypoglycemic event threshold; for atleast a subset of the identified hypoglycemic events, prompting theperson to provide information associated with each hypoglycemic eventusing a graphical user interface on the display device, wherein: thegraphical user interface includes a plurality of hypoglycemic eventicons, each hypoglycemic event icon including an indicator that showshow commonly the respective hypoglycemic event icon is selected by theperson using (i) a numeral, (ii) icon shading, and/or (iii) iconcoloring; and the information includes one or more of: symptomsassociated with the respective hypoglycemic event; perceived causes ofthe respective hypoglycemic event; and treatment for the respectivehypoglycemic event; in response to the prompting, obtaining feedbackfrom the person about the identified hypoglycemic events using thegraphical user interface on the display device; and providing a reporton the display device that includes at least a subset of the obtainedfeedback.
 15. The computer system of claim 14, the one or more programsfurther comprising instructions for: transmitting the received pluralityof blood glucose readings and the obtained feedback to a secondcomputing device to identify one or more patterns of hypoglycemicevents.
 16. The computer system of claim 14, wherein the provided reportincludes a hypo awareness grid, including a first axis that shows bloodglucose level, a second axis that shows reported symptoms, and entriesin the grid indicating how many hypoglycemic events had a specific(glucose level, symptom) pair.
 17. The computer system of claim 14, theone or more programs further comprising instructions for: analyzing theidentified hypoglycemic events and the obtained feedback to identify oneor more patterns of hypoglycemic events; and including the identifiedone or more patterns of hypoglycemic events in the provided report. 18.The computer system of claim 17, wherein the identified one or morepatterns of hypoglycemic events include a correlation betweenhypoglycemic events and time of day or day of week.